Yoo Jun-Il, Ha Yong-Chan, Lee Han-Jun, Lee Jung-Yeop, Lee Young-Kyun, Koo Kyung-Hoi
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Sungnam, South Korea.
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-ku, Seoul, 156-755, South Korea.
Knee Surg Sports Traumatol Arthrosc. 2017 Jun;25(6):1951-1957. doi: 10.1007/s00167-016-4402-9. Epub 2016 Dec 21.
The study determined the prevalence of subspinal impingement (SSI) in symptomatic and asymptomatic individuals, morphologic characteristics in symptomatic patients, and risk factors for SSI.
The study cohort consisted of 427 patients (427 hips; median age 33.4 years; range 19-50 years) with mechanical symptoms who underwent multi-detector computed tomography arthrography (symptomatic patients) and 259 control (asymptomatic) patients who underwent abdominopelvic three-dimensional CT because of a ureter stone or minor trauma. Two orthopaedic surgeons reviewed the images to evaluate the prevalence of SSI and the relationship with morphologic abnormalities. Radiologic parameters were further compared between the SSI and non-SSI groups in symptomatic patients using the Chi-squared test or two-sample t test. Variables with p values <0.10 (sex and age) were included in the multi-variate analysis. Logistic regression analysis was carried out to identify independent risk factors for SSI.
The prevalence of SSI in symptomatic and asymptomatic patients was 65/427 (15.2%) and 40/259 (15.4%), respectively (n.s.). Structural bony abnormalities in symptomatic patients were not associated with the presence of SSI (n.s.). Binary logistic regression analysis revealed that youth (odds ratio 0.952, 95% CI 0.922-0.984) was the only significant factor for SSI.
SSI had a similar prevalence in symptomatic and asymptomatic patients and was not rare in either group. Therefore, clinical implication of SSI in symptomatic patient should be re-evaluated through further study.
Level IV.
本研究确定有症状和无症状个体中脊柱下撞击（SSI）的患病率、有症状患者的形态学特征以及SSI的危险因素。
研究队列包括427例有机械性症状的患者（427髋；中位年龄33.4岁；范围19 - 50岁），这些患者接受了多排螺旋CT关节造影（有症状患者），以及259例对照（无症状）患者，他们因输尿管结石或轻度外伤接受了腹部盆腔三维CT检查。两名骨科医生对图像进行了评估，以评估SSI的患病率及其与形态学异常的关系。使用卡方检验或两样本t检验，进一步比较有症状患者中SSI组和非SSI组的放射学参数。p值<0.10的变量（性别和年龄）纳入多变量分析。进行逻辑回归分析以确定SSI的独立危险因素。
有症状和无症状患者中SSI的患病率分别为65/427（15.2%）和40/259（15.4%）（无统计学差异）。有症状患者的结构性骨异常与SSI的存在无关（无统计学差异）。二元逻辑回归分析显示，年轻（比值比0.952，95%可信区间0.922 - 0.984）是SSI的唯一显著因素。
SSI在有症状和无症状患者中的患病率相似，且在两组中均不罕见。因此，应通过进一步研究重新评估SSI在有症状患者中的临床意义。
IV级。
